Arguing against a move to WHO Phase 5 for H1N1 swine flu
Everyone who has read this blogsite for any duration of time knows of my quest to get the WHO to raise the pandemic threat level from 3 to 4.
Two days ago, and for a wildly different reason, the WHO has seen fit to do just that. Now there is speculation that the WHO is about to raise that pandemic threat level again, to Phase 5.
I think that is a bad idea. I will wait while you pick up your jaw from the floor.
OK, let's talk.
It took a mammoth event to get the WHO off the schnide in the first place. Now, with the pandemic alert level at 4 of 6, I think we should let that level sink in a bit. The WHO cannot be seen as crying wolf, especially if there is no evidence that the virus is causing massive, exponential infections beyond those unfortunates who recently traveled to Mexico.
We will see evidence of these expanded infections quickly if they are to come. Evidence of expanded infections would mean the virus is causing widespread infections. I don't mean an infection or two in a town that does not go beyond a person or a family. I mean infections that go from 5 to 100 in a couple of days.
A lack of same would mean this virus may have temporarily lost some of its bluster. "Temporarily" could be a few days, a few weeks or the virus could lay dormant until the late summer or early fall -- just like 1918.
I just don't think we are seeing the groundswell (yet) in cases that would signify a raising to Phase 5. If -- and I mean IF -- the WHO raises the threat level, it could be because there are so many nations reporting a pocket of cases in a number of countries. But there is so much surveillance going on now that evidence of a rapid expansion of cases beyond those people who recently traveled to Mexico would be quickly forthcoming.
We are also not seeing an exponential increase in Mexican cases. If this virus was lethal, we would see a continuing acceleration of extreme respiratory distress, and an increase in deaths. In the past two days, these Mexican cases haveapparently slowed down. This is decidedly good news and we all certainly hope that this trend continues.
Everyone is prepositioning assets in the field. We have anecdotal evidence of increased Federal activity right here in Florida, and I am certain other states have similar initiatives underway. Everyone is on alert and on their guard. So let's let Phase 4 do its thing -- what it was designed to do -- and get everyone moving to prepare for Phases 5 and 6. Tell people what to buy and how to recognize infection. But let's not pull that Phase 5 trigger unless and until the number of follow-on cases have justified the acceleration.
Of course, there is always the possibility that things are afoot that no one knows about. But I do not think that anyone knows enough about this virus at this point that would justify a move to Phase 5. Scientists and researchers are having trouble why this virus has changed its business model to sicken humans, when there are no apparent major changes to be seen in either the HA or NA strands.
One more thing: because of the Guillain-Barre side effect problems back in 1976, the government and vaccine makers had better make damn sure there is nothing in that syrup to prompt the kind of anomaly that occurred in 1976. And putting it in the trivalent fall cocktail makes a hell of a lot of sense.
Phase 5 is the equivalent of the Department of Homeland Security going to Code Red. In both cases, the only next available step is "Holy *#&#!"
Phase 5 triggers a number of corporate and government responses, and they all cost money and effort. Let's not move to Phase 5 unless there is demonstrable, defensible evidence that this virus is causing massive infections growing out of those limited number of clusters. It is a huge move and should not be taken lightly.
Reader Comments (4)
I agree. I was just starting to think it is like a normal flu just very transmissible. I'd wait a day. But then do they have more info than we do? All these samples take days to type for sure. Lots of speculation, but is it really THE strain of concern?
I just want to say that here in Montana, no one is very concerned. Not our state health department either. One post on their site. No swine flu here. oh great.
Too late. We're at 5.
Same here in GA. No one seems very concerned. The local news is carrying stories, but that's what they do. Life is pretty much as it was, no different; making plans as normal. No one I know is even talking about it. I, however, was buying some supplies at Costco and Target today and feeling a bit of a freak. At least I'll be a prepared freak.
I'm still not convinced the swine flu hasn't been circulating silently masquerading as the seasonal flu. My family's experience in late March with most of us catching the flu (identified as Type A and not subtyped) was sort of weird as we all had the vaccine. My husband felt like he was dying for 3 weeks.
Fine, we're at 5. I wish the authorities would trust the general public and tell us more.
I appreciate your expertise in thses matters and appreciate your blog as a source of education for me and for others, so I am hesitant to venture an opinion. Still, you mentioned,
"it could be because there are so many nations reporting a pocket of cases in a number of countries. ... "
and you also mentioned the virus' lethality.
It is my understanding, limited as it is, that the declaration of pandemic or the increase in alert stage has everything to do with your first point (the fact that so many nations have reports) and nothing to do with lethality.
Thanks for all you do here. Keep up the good work.